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Fighting TB in Gauteng

People know about TB, but knowing about TB isn’t the same as having information on what to do when you have TB, especially amongst residents of informal settlements.”   – Thapelo Mokone, District Coordinator, Treatment Action Campaign.

Community organisations in South Africa are facing an uphill battle in their efforts to link people to TB care and improve case finding rates. Several challenges were identified and potential solutions came to light during a Community Dialogue held in Randfontein, Gauteng, part of NACOSA’s Community Systems Strengthening Programme funded by The Global Fund.

The stigma associated with TB is one of the biggest challenges that exists in communities. Due to the false link between TB and HIV, people who live in informal settlements, especially the youth, frequently avoid seeking medical attention because they are afraid of being associated with HIV. They treat every chronic illness as HIV and believe that it is incurable, there is serious need for public education to stop this belief and reassure people that TB is treatable and not a death sentence.

Mpumelelo Kona of Vuka Ukhanye Community Development said. “People attach TB symptoms to HIV. They need to know that TB is not a death sentence and it is something that can be cured, so we still have a lot of work in our community in terms of creating awareness.”

“Stigma is one of the greatest challenges faced in linking people to care. Young people in particular find it difficult,” shared Morgan Jantjies, Chairperson of the Zazele Foundation.

In order to separate TB from HIV and to address societal misconceptions, public education is extremely Important. People need to recognise the seriousness of this health issue and take steps to the fight against TB. “We are going to make sure that organisations have information regarding the TB health check that enables people to screen yourself at home,” noted Sonnet Modisane, TB Programme Manager, West Rand District.

TB is a very serious health issue, therefore raising public awareness about its prevention, symptoms, and treatment is very important. However, many community organisations still struggle to reach a large number of people, particularly in rural areas as they do not have the means to transport their team members to further remote populations. This transportation barrier does not only prevent their ability to undertake outreach programmes, but also their ability to give early detection and support to those who may be affected.

“We need to pool resources to make up for each other’s challenges in order for the work to go on,” emphasised Morgan Jantjies, Chairperson of Zazele Foundation.

Some TB patients in informal settlements default their treatments due to lack of resources such as health care facilities, and others factors such as transportation issues and food insecurity. Although the government has started to address these problems, there is still a lot of work that needs to be done.

It is concerning that businesses are not doing enough to assist in fighting TB, particularly in mining areas. Big corporates in these areas have a social duty to make considerable contributions to the TB fight. Due to the living and working conditions in mining communities, it is crucial for corporates to recognise that their actions, or lack thereof, have a direct impact on the health and well-being of the people living and working in these areas, and they must step up to fulfil their responsibilities in the fight against TB. This involves putting in place health and safety regulations, providing routine personnel screenings, and making investments in the local healthcare system.

The arrival of the COVID-19 pandemic has had far-reaching consequences for the healthcare system, which has resulted in the neglect of other essential health crises such as TB and HIV. Because of the overwhelming emphasis on COVID-19 management, resources, attention, and healthcare workers were diverted away from established programmes for TB and HIV patients. People living with TB require constant care, monitoring, and access to treatment, service disruptions have resulted in delayed diagnoses, interrupted treatment regimens, and a general worsening in the health and well-being of these vulnerable populations. It is critical that healthcare facilities maintain a balance between addressing an immediate pandemic such as COVID-19 and maintaining essential services for TB treatment.

“COVID-19 has affected our organisation and our community. Families have lost breadwinners, and children are left without parents,” added Mpumelelo Kona of Vuka Ukhanye Community Development.

Although challenges still exist; government support, public awareness initiatives, and collaboration give hope for the future of the fight against TB in informal settlements. Collaboration between the Department of Health, the local AIDS council, NGOs and the civil society is needed in order to effectively overcome these challenges. “The more we engage, the more we start sharing ideas and the more we see viable ways of solving the challenges that we are currently having.” Added Morgan Jantjies.